Birth outcomes in a tertiary teaching hospitals and local outposts: a novel approach to service delivery from Iran

Which low- and middle-income countries have midwife-led birthing centres and what are the main characteristics of these centres? A scoping review and scoping survey

“…Some of the peer-reviewed literature included an attempt to measure the impact of MLBCs, using a variety of outcome measures. Most reported positive outcomes to MLBC births such as low mortality and morbidity rates ( Anonymous, 2012 ; David et al., 2012 ; Moudi and Tabatabaei, 2016 ; Ngongo et al., 2013 ; Progianti et al., 2013 ; Schneck et al., 2012 ), low intervention rates ( Alonso et al., 2021 ; Caldas Nicacio et al., 2016 ; David et al., 2012 ; Ngongo et al., 2013 ; Schneck et al., 2012 ; Wallace, 2019 ) and high quality of care ( Akhtar et al., 2017 ; da Silva et al., 2013 ; David et al., 2012 ; Freitas et al., 2019 ). The main exceptions were the evidence from South Africa of high rates of disrespect and abuse ( Dutton and Knight, 2020 ; Malatji and Madiba, 2020 ; Oosthuizen et al., 2020 , 2017 ; Zitha and Mokgatle, 2020 ), and the evidence from Brazil of some ineffective or potentially harmful practices in MLBCs ( da Silva et al., 2013 ; Freitas et al., 2019 ).…”

“…Not all of the studies in this review had the aim of comparing MLBCs with other birthplace options. Amongst those that did, the most common comparator was the obstetric unit of a public sector hospital ( Alonso et al., 2021 ; Caldas Nicacio et al., 2016 ; Diba et al., 2019 ; Freitas et al., 2019 ; Hofmeyr et al., 2014 ; Moudi et al., 2014 ; Moudi and Tabatabaei, 2016 ; Schneck et al., 2012 ). Other studies compared MLBC outcomes with national figures ( da Silva et al., 2012 ), or compared the population served by an MLBC against a ‘control’ population without access to an MLBC ( Wallace, 2019 ).…”

Exploring networks of care in implementing midwife-led birthing centres in low- and middle-income countries: A scoping review

“…Being responsive to needs includes enabling meaningful interactions with women and their communities to address their individual, cultural and emotional needs and supporting women and their families to feel safe, confident and included in their care. Thirteen papers addressed these needs [ 20 , 23 – 25 , 28 , 29 , 32 – 34 , 38 , 41 , 48 , 50 ].…”

“…Fifteen studies addressed issues related to buy-in and trusting relationships [ 16 , 20 , 23 , 25 , 26 , 28 , 31 – 34 , 37 , 41 , 43 , 50 , 51 ]. Continuity of care, positive communication and informed decision making, non-medicalised approaches, and context-specific needs were critical elements of buy-in and trusting relationships.…”

“…The integration of MLBCs within an established referral system improves confidence and a sense of safety among service users. Seventeen articles mentioned issues related to referral systems [ 5 , 20 , 21 , 23 – 26 , 30 , 39 – 41 , 46 – 48 , 50 – 52 ]. In all settings, some sort of referral system was in place, but in many cases, it did not function well due to a lack of ambulances and/or equipment and geographical challenges.…”